Does mitomycin-C concentration have any influence on XEN45 gel stent outcomes in a real-world setting?

Monja-Alarcón, Natalia; Perucho-Martínez, S; Buenasmañanas-Maeso, Miriam; Toledano-Fernández, N.

doi:10.1007/s00417-022-05603-y

Cited by 5 publications

(7 citation statements)

References 28 publications

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“…A study comparing the efficacy and safety of two MMC doses (0.01% versus 0.02%) in eyes who underwent a XEN45 device implant, either alone or in combination with phacoemulsification, was recently published [ 95 ]. The results of this study found that IOP lowering, number of hypotensive medication reduction, or incidence of adverse events were not related to MMC concentration [ 95 ]. The lack of significant differences, in terms of IOP lowering or reducing hypotensive medications, between MMC 0.01% and MMC 0.02% raises the possibility of using lower doses of MMC.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

Traverso

Carassa²,

Fea

et al. 2023

JCM

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Although topical medical therapy and selective-laser-trabeculoplasty represent the treatments of choice to reduce intraocular pressure, many patients do not achieve adequate glaucoma control; therefore, they require further options and eventually surgery. Trabeculectomy is still considered the gold standard, but the surgical management of glaucoma has undergone continuous advances in recent years, XEN-gel-stent has been introduced as a safer and less traumatic means of lowering intraocular pressure (IOP) in patients with open-angle glaucoma (OAG). This study aimed to review the effectiveness and safety of clinical data on XEN-stent in OAG patients with a Synthesis-Without-Meta-analysis (SWiM) methodology. A total of 339 studies were identified following a literature search adhering to PRISMA guidelines and, after evaluation, 96 studies are discussed. XEN63 and XEN45 device data were collected both short and long term. In addition, this document has evaluated different aspects related to the XEN implant, including: its role compared to trabeculectomy; the impact of mitomycin-C dose on clinical outcomes; postoperative management of the device; and the identification of potential factors that might predict its clinical outcomes. Finally, current challenges and future perspectives of XEN stent, such as its use in fragile or high myopia patients, were discussed.

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Section: Resultsmentioning

confidence: 99%

“…The lack of significant differences, in terms of IOP lowering or reducing hypotensive medications, between MMC 0.01% and MMC 0.02% raises the possibility of using lower doses of MMC. However, it should be mentioned that MMC 0.01% was not associated with lower incidence rates of adverse events [ 95 ].…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

Traverso

Carassa²,

Fea

et al. 2023

JCM

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“…XEN implant was placed, under topical anesthesia, in the superior nasal quadrant using a standard ab interno technique following a previously described technique, 23,24 under topical anesthesia. Intraoperatively, 0.1 mL of mitomycin-C (MMC) 0.01% or 0.02% was subconjunctivally injected under the Tenon capsule, depending on the estimated preoperative risk of fibrosis.…”

Section: Xen 45mentioning

confidence: 99%

“…[14][15][16][17] Different studies have shown the good intraocular pressure (IOP)-lowering effect of the XEN device, either alone or in combination with cataract surgery, in patients with glaucoma. [18][19][20][21][22][23][24] Indeed, the results of a systematic review and meta-analysis published recently have shown a mean (95% CI) IOP lowering from a baseline of -7.8 (-7.4 to -8.2) mm Hg and -8,4 (-6.9 to -9.8) mm Hg in the eyes who underwent XEN-solo and XEN+Phacoemulsification, respectively. 25 Despite the large amount of available evidence that has evaluated the efficacy and safety of the NPDS and XENprocedures, as far we know, only 1 study has compared these 2 surgeries in solo procedure 26 and only 1 retrospective study has compared them in combination with cataract surgery.…”

mentioning

confidence: 99%

“…Different studies have shown the good intraocular pressure (IOP)–lowering effect of the XEN device, either alone or in combination with cataract surgery, in patients with glaucoma 18–24. Indeed, the results of a systematic review and meta-analysis published recently have shown a mean (95% CI) IOP lowering from a baseline of -7.8 (-7.4 to -8.2) mm Hg and -8,4 (-6.9 to -9.8) mm Hg in the eyes who underwent XEN-solo and XEN+Phacoemulsification, respectively 25…”

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confidence: 99%

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XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy in Ocular Hypertension and Open Angle Glaucoma Patients

Almendral-Gómez

Perucho-Martínez

Martín-Giral

et al. 2023

Journal of Glaucoma

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Précis: XEN gel stent and nonpenetrating deep sclerectomy, both either alone or in combination with cataract surgery, significantly lowered the intraocular pressure (IOP) and reduced the number of antiglaucoma medications in patients with open angle glaucoma, with no significant differences between them. Purpose: To compare the surgical outcomes of XEN45 implant and nonpenetrating deep sclerectomy (NPDS), either alone or in combination with cataract surgery, in patients with ocular hypertension and open angle glaucoma (OAG). A retrospective and single-center cohort study was conducted on consecutive patients who underwent a XEN45 implant or an NPDS, either alone or in combination with phacoemulsification. The primary endpoint was the mean change in IOP from the baseline to the last follow-up visit. One hundred twenty-eight eyes, 65 (50.8%) eyes in the NPDS group and 63 (49.2%) eyes in the XEN group, were included in the study. The mean preoperative IOP was significantly lowered from 17.6±5.3 mm Hg and 17.8±6.2 mm Hg to 12.6±2.6 mm Hg and 13.8±2.8 mm Hg at month 12 in the XEN and NPDS groups, respectively; P<0.0001 each. At month 12, 70 (54.7%) eyes were classified as a success, with no significant differences between XEN (57.1%; 36/63 eyes) and NPDS (52.3%; 34/65 eyes) (mean difference: 4.8%; 95% CI: −30.5% to 20.8%; P=0.7115). The number of ocular hypotensive medications was significantly reduced in the XEN (from 2.1±0.7–0.2±0.5, P<0.0001) and in the NPDS (from 2.0±0.8 to 0.3±0.6, P<0.0001) groups, with no significant differences between them (P=0.2629). The incidence of postoperative adverse events in the overall study population was 12.5%, with no significant differences between groups (P=0.1275). Seven (11.1%) eyes underwent needling (XEN group) and 10 (15.4%) goniopuncture (NPDS group); P=0.4753. Conclusions: XEN45 implant and the NPDS, either alone or in combination with cataract surgery, significantly lowered IOP and reduced the number of ocular hypotensive medications in ocular hypertension and patients with open angle glaucoma.

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Three-Year Results of XEN-45 Implantation for Glaucoma Secondary to Fuchs Uveitis Syndrome, Intermediate Uveitis, and Juvenile Idiopathic Arthritis-Related Anterior Uveitis

Nasyrov,

Merle,

Doycheva

et al. 2024

Ocular Immunology and Inflammation

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Does mitomycin-C concentration have any influence on XEN45 gel stent outcomes in a real-world setting?

Cited by 5 publications

References 28 publications

Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy in Ocular Hypertension and Open Angle Glaucoma Patients

Three-Year Results of XEN-45 Implantation for Glaucoma Secondary to Fuchs Uveitis Syndrome, Intermediate Uveitis, and Juvenile Idiopathic Arthritis-Related Anterior Uveitis

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